Management of atypical squamous cells, low-grade squamous intraepithelial lesions, and cervical intraepithelial neoplasia 1

Obstet Gynecol Clin North Am. 2008 Dec;35(4):599-614; ix. doi: 10.1016/j.ogc.2008.09.001.

Abstract

In the American Society for Colposcopy and Cervical Pathology 2006 Consensus Guidelines, several changes in the management of mildly abnormal cervical cytology and histology were made. The most notable changes involve the management of adolescents, pregnant women, and postmenopausal women. For adolescents, management of atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions is conservative, eliminating the need for immediate colposcopy. For pregnant women, options have been made to allow for deferral of colposcopy until pregnancy completion, whereas for postmenopausal women, the new guidelines call for the option to rely on human papillomavirus DNA testing or repeat cytology to manage mild cytologic abnormalities. The guidelines for cervical intraepithelial neoplasia 1 now focus on conservative management. The goal of this article is to review the 2006 Guidelines, elaborating on the changes and providing the rationale for management decisions.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Cervix Uteri / cytology
  • Cervix Uteri / pathology
  • Colposcopy / methods
  • Female
  • Humans
  • Mass Screening / methods
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / therapy*
  • Precancerous Conditions / classification
  • Precancerous Conditions / diagnosis
  • Precancerous Conditions / therapy
  • Precancerous Conditions / virology
  • Tumor Virus Infections / diagnosis
  • Tumor Virus Infections / pathology
  • Tumor Virus Infections / therapy*
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / therapy*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / therapy*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears